• Pharyngitis and tonsillitis are most commonly seen in children between the ages of 6 and 8.
• Children under age 2 rarely develop group A ß - hemolytic streptococcus (GABHS), or strep throat.

• Viruses:

  • Adenovirus.

  • Influenza virus.

  • Epstein-Barr virus.

  • Herpes simplex virus.
    

• Bacteria:

  • Group A ß - hemolytic streptococci (GABHS).

  • Neisseria gonorrhea.

  • Haemophilus influenzae Type B.

  • Mycoplasma.
    

• Fungal infections.

• Parasitic infections.

• Cigarette smoke.

• Antibiotics overuse

  Antibiotic overuse in children has become a common problem, aggravated by parental pressure for the medication, according to the American Academy of Pediatrics (AAP). In 1980, 4.2 million prescriptions were written for amoxicillin, an oral antibiotic to treat ear infections. In 1992, the number of prescriptions had grown to 12.3 million (194 percent increase). Use of another antibiotic to treat ear infections, cephalosporins, increased from 876,000 prescriptions in 1980 to 6.8 million in 1992 (a 687 percent increase). Overuse of antibiotics is leading to strains of diseases that are becoming resistant to the medication, making it harder to treat patients. All too often, antibiotics have been prescribed for conditions such as colds, fluid in the middle ear, or bronchitis, which do not respond to antibiotics, according to the Centers for Disease Control and Prevention (CDC). Antibiotics are only effective in treating bacterial infections. The key to preventing overuse of antibiotics is education of the parents and physicians in the appropriate use of antibiotics, according to the AAP. Some tips to remember when taking antibiotics, according to the American Medical Association (AMA), include the following: Take the antibiotics as prescribed. Finish the full course of antibiotics, as prescribed. Do not save or reuse antibiotics. Always consult your child's physician for more information.

  Sore throat.

• Fever (either low grade or high).

• Headache.

• Decrease in appetite.

• Not feeling well.

• Nausea.

• Vomiting.

• Stomach aches.

• Painful swallowing.

• Visual redness or drainage in the throat.

How are pharyngitis and tonsillitis diagnosed?
In most cases, it is hard to distinguish between a viral sore throat and a strep throat based on physical examination. It is important, though, to know if the sore throat is caused by GABHS, as this requires antibiotic treatment to help prevent the complications associated with these bacteria.

As a result, most children, when they have the above symptoms, will receive a strep test and throat culture to determine if it is an infection caused by GABHS. This usually involves a throat swab (called quick tests or rapid strep tests) in the physician's office. 

This may immediately become positive for GABHS and antibiotics will be started. If it is negative, part of the throat swab will be kept for a throat culture. This will further identify, in two to three days, if there is any GABHS present. Your child's physician will decide the treatment plan based on the findings.

Treatment for pharyngitis and tonsillitis:
Specific treatment for pharyngitis and tonsillitis will be determined by your child's physician based on:

• Your child's age, overall health, and medical history.
• Extent of the condition.
• Cause of the condition.
• Your child's tolerance for specific medications, procedures, or therapies.
• Expectations for the course of the condition.
• Your opinion or preference.

If bacteria do not cause the infection, then the treatment is focused on the comfort of your child. Antibiotics will not help treat viral sore throats. Treatment may include:

• Acetaminophen (for pain).

• Increased fluid intake.

• Throat lozenges.

• Antibiotics (if the cause of the infection is bacterial, not viral).

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